We are all wondering about Thanksgiving this year. I want to give some clear guidance that I’m hearing from nearly every other public health official, city leader, healthcare worker, hospital administrator, and epidemiologist I know – and all that I trust.
It is recommended 𝐭𝐨 𝐝𝐨 𝐓𝐡𝐚𝐧𝐤𝐬𝐠𝐢𝐯𝐢𝐧𝐠 𝐎𝐍𝐋𝐘 𝐰𝐢𝐭𝐡 𝐨𝐮𝐫 𝐢𝐦𝐦𝐞𝐝𝐢𝐚𝐭𝐞 𝐟𝐚𝐦𝐢𝐥𝐲. 𝐈𝐟 𝐲𝐨𝐮 𝐡𝐚𝐯𝐞𝐧’𝐭 𝐚𝐥𝐫𝐞𝐚𝐝𝐲 𝐜𝐚𝐧𝐜𝐞𝐥𝐥𝐞𝐝 𝐰𝐢𝐭𝐡 𝐚𝐥𝐥 𝐞𝐱𝐭𝐞𝐧𝐝𝐞𝐝 𝐟𝐚𝐦𝐢𝐥𝐲, 𝐢𝐭 𝐢𝐬 𝐫𝐞𝐜𝐨𝐦𝐦𝐞𝐧𝐝𝐞𝐝 𝐰𝐞 𝐝𝐨 𝐭𝐡𝐚𝐭. 𝐂𝐞𝐥𝐞𝐛𝐫𝐚𝐭𝐞 𝐢𝐧 𝐅𝐞𝐛𝐫𝐮𝐚𝐫𝐲 𝐨𝐫 𝐌𝐚𝐫𝐜𝐡 (𝐭𝐡𝐚𝐭’𝐬 𝐰𝐡𝐚𝐭 𝐰𝐞 𝐚𝐫𝐞 𝐝𝐨𝐢𝐧𝐠), 𝐝𝐨 𝐚 𝐳𝐨𝐨𝐦-𝐓𝐡𝐚𝐧𝐤𝐬𝐠𝐢𝐯𝐢𝐧𝐠, 𝐛𝐞 𝐜𝐫𝐞𝐚𝐭𝐢𝐯𝐞.
✅ The exception – If your family and all extended family you will come in contact with have been doing a strict quarantine (which is really hard for lots of us in schools/workplaces/etc and does not mean we can “test” into meeting together) since November 11th (14 days prior to Thanksgiving) – see this post when I mentioned what a legit quarantine is – legit means legit for everyone coming: https://tinyurl.com/y5b38lw8
I know that many are trying to figure out various scenarios to make Thanksgiving work: Can I be really careful while traveling by plane, can we wear a mask indoors, can we “test” everyone in, can we fill-in-the-blank? A month ago, we could probably talk through some of those nuances and details. But today with the cases high in nearly all parts of the country and rising faster than we have seen before (which comes before hospitalizations and deaths), those nuances and “trying to make it work” are not enough.
𝐋𝐞𝐭 𝐦𝐞 𝐬𝐡𝐨𝐰 𝐲𝐨𝐮 𝐰𝐡𝐲. 𝐇𝐚𝐯𝐞 𝐲𝐨𝐮 𝐬𝐞𝐞𝐧 𝐭𝐡𝐢𝐬 𝐭𝐨𝐨𝐥? https://covid19risk.biosci.gatech.edu/
It’s a great (and trusted) risk-assessment tool that is COUNTY-SPECIFIC based on case rates (over the past 10 days), current positivity rates, and takes into account the population in the county. Let me show you how it works:
✅ 𝐒𝐭𝐞𝐩 𝟏 – Look on the left side of the tool and click on the ‘event size’. That’s the number of people you expect to come to the holiday get-together. That needs to be the number you come into contact with over the holiday weekend – not simply the ones coming to the dinner table or staying at your house. If they come for 30 minutes for a visit, count them. If they bring 2 kids for 20 minutes, count them and the kids.
✅ 𝐒𝐭𝐞𝐩 𝟐- Look at the left side of the tool and click on the ‘ascertainment bias’. This measures how many cases are NOT being detected in your area. Think of this like the positivity rates – if those are high, that means we are not testing enough. If you have high positivity rates (above 8-10% in your area), I would move the ascertainment bias to 10. If you don’t know your positivity rate, it’s probably above 8-10% since most of the country is anyways. Go here for positivity rates in your state: https://www.covidexitstrategy.org/
✅ 𝐒𝐭𝐞𝐩 𝟑 – Hover over your county and see what the risk % is. 𝐓𝐡𝐚𝐭 𝐰𝐢𝐥𝐥 𝐭𝐞𝐥𝐥 𝐲𝐨𝐮 𝐭𝐡𝐞 𝐜𝐡𝐚𝐧𝐜𝐞 𝐭𝐡𝐚𝐭 𝐬𝐨𝐦𝐞𝐨𝐧𝐞 𝐚𝐭 𝐲𝐨𝐮𝐫 𝐡𝐨𝐥𝐢𝐝𝐚𝐲 𝐭𝐚𝐛𝐥𝐞 𝐰𝐢𝐥𝐥 𝐡𝐚𝐯𝐞 𝐂𝐎𝐕𝐈𝐃-𝟏𝟗. Remember, lots can be asymptomatic and have really mild symptoms (like allergies) and still spread to Grandma. People are also really contagious 2 days PRIOR to showing symptoms and knowing they are sick (see sources for the post explaining this).
***When you’re thinking about who might be coming to your Thanksgiving get-together, look at the risk in the county they are coming from. So, if you have an uncle coming from Lea County in NM and cousins flying from Nashville TN to all meet in Franklin MO, look at the risk % is all counties. Risks will mix and compound.
✅ 𝐒𝐭𝐞𝐩 𝟒 – Consider rethinking your plans. For most of us this means to cancel. Reschedule Thanksgiving for spring/summer 2021. Schedule a zoom call. Eat some cookies and it’s ok to cry. I know I did this week when we were talking through this with our families. We are pivoting to do fun activities with the kids through zoom (Dad, I’m asking you to dress as a turkey! Surprise!) But, it will be different – I do get that. It’s not forever though. It just stinks today.
✅ 𝐒𝐭𝐞𝐩 𝟓 – Remember that this risk tool will likely look more “red” next week with the exponential rise in cases in the country.
***As an example for my family, we would travel to Lubbock, Texas to see my family for the holidays. If you find Lubbock, Texas (panhandle of Texas) – the risk is 90% right now for a family get-together of 15 and 78% for 10 people (which is on the small-end of our extended family). For McLennan County, Texas (where I currently live), the risk is 54% for 15 people. In “risk” terms, 54%, 78%, and 90% is really high – especially with the mixing of families.
***A special note for the Grammy/Nana/Neena (my mom)/Grandma – My mom and mom-in-love are the type of moms where we would bring home 10 friends from college to Thanksgiving. If someone (or eight people) from church didn’t have anyone to celebrate with, they would come over. If our neighbors needed a place to come, they would come over. So our Thanksgivings were usually really big and loud and I loved it and have continued that tradition at my own home in years past. This is not the year to do that. If you have a Grammy/Nana/Mom/Grandma that is having a hard time turning people down for the holidays, having a hard time not seeing the grandkids, or having a hard time asking their grown children not to come this year – maybe we could make it easier for them and decide to celebrate in the Spring. Maybe we could make it easier on them and decide ourselves not to come. I think it’s harder for some of the Nanas to say ‘No’ when we ask ‘Do you think we should come?’ and leave it up to them. Just a thought on how to make this easier for our families. If your older parents need help saying ‘no’, maybe we can help them do that.
I’m really hopeful that we are SO close to getting a vaccine for the Grandmas and Grandpas. It’s around the corner, web-peeps and I’ll right about that today. Until then, hard decisions and conversations probably need to be had.
*** I do realize there are circumstances like knowing this is a loved one’s last Thanksgiving and I’ve heard that from many of you this week. For most of us, loving our families means staying home to keep everyone healthy. For others like you, loving our families means layering in these extenuating circumstances that cannot be quantified in numbers or percentages on top of everything else. If you find yourself in that situation, I’m so sorry about that for your family. There aren’t easy answers in these situations, so I encourage you to think in terms of love, care, and wisdom. What is the most loving and caring thing, and how can it be pursued wisely with masks, outdoors versus indoors, etc? I’ll be praying for you in these hard times.
-Friendly neighbor epidemiologist
Risk assessment tool – https://covid19risk.biosci.gatech.edu/
When is someone contagious? https://tinyurl.com/y4rfjmc5
14 day quarantine should have started last week: https://tinyurl.com/y5b38lw8